Young Men's Aggressive Tactics to Avoid Condom Use: A Test of a Theoretical Model

Article excerpt

Although research has demonstrated that men's aggression against women and inconsistent condom use are related phenomena, little is known about what factors increase risk for aggression to avoid condom use. The present article tests a theory-based model of condom avoidance through use of sexual aggression. Adult male participants (N = 289) were recruited nationally through online advertisements. Aggressive tactics to avoid condom use were measured using an adapted version of the revised Sexual Experiences Survey, and a variety of aggressive behaviors spanning coercion to physical force were assessed. One hundred participants (35.3%) reported at least one instance of coercion or aggression to avoid using a condom. Structural equation modeling indicated that attitudes toward women, inconsistent condom use, and number of sexual partners were significant predictors of aggressive tactics to avoid condom use. A better understanding of the attitudinal and behavioral pathways through which men avoid condom use through aggressive and coercive means will ultimately result in improved education and prevention efforts for at-risk men and women.

Despite prevention efforts, sexual assault remains a widespread public health concern estimated to affect 25% of women in the United States, with approximately 300,000 women raped each year (Koss, 1988; Tjaden & Thoennes, 2006). Sexual assault may adversely affect a woman's physical and mental health in a variety of ways, including negative sexual and reproductive health consequences. For example, sexual assault involving penetration results in 3% to 20% of victims acquiring a sexually transmitted infection (STI) (Jenny et al., 1990; Tjaden & Thoennes, 2006). Among women of reproductive age, approximately 5% of those raped became pregnant from the assault, with more than 32,000 pregnancies resulting from rape each year (Holmes, Resnick, Kilpatrick, & Best, 1996). Empirical research investigating the factors that may increase the likelihood of these negative consequences for sexual assault victims would further inform efforts to reduce these harmful outcomes.

The use of a condom during penetrative sexual assault, as during consensual sexual situations, can decrease the risk of both STI transmission and unwanted pregnancies. Although there is very little published research regarding the use of condoms during sexual assault events, these few studies indicated that sexually aggressive acts involving penetration often do not involve condom use (Davis, Schraufnagel, George, & Norris, 2008; Peterson, Janssen, & Heiman, 2010; Raj et al., 2006). For example, Davis et al. found that approximately 40% of sexual assault perpetrators reported that they never used condoms during their assaults, whereas another 30% reported using condoms inconsistently. This nonuse of condoms during rape may be more likely than unprotected consensual sex to result in STI transmission because of the higher likelihood of vaginal tissue injury in sexual assault incidents (Briere, 2004). Moreover, because men who report engaging in sexual or physical violence against women also report more sexual partners (for example, number of partners in the last year, one-night stands) and inconsistent or no condom use during consensual vaginal and anal sexual intercourse, they present an elevated STI transmission risk to their victims (Peterson et al., 2010; Raj et al., 2006).

Because of these associations between sexual violence and risky sexual behavior in heterosexual men, researchers have started examining men's use of coercive and forceful strategies to obtain unprotected sex from a female sex partner who wants to use a condom (Abbey, Parkhill, Jacques-Tiura, & Saenz, 2009; Davis, 2010). Compared with non-perpetrators, men who had previously committed sexual assault reported greater justification for using coercive tactics to obtain unprotected sex in a hypothetical situation (Abbey et al. …